Chapter 14 The Reproductive Systems Part 3

○ Menstrual Disorders ■ Amenorrhea = an abnormal absence of menstrual periods for 90 days or more; this condition is normal only before puberty, during pregnancy, while breastfeeding, and after menopause; can be caused by stress, hormonal problems, inadequate nutrition, or excessive exercise. ■ Dysmenorrhea = pain caused by uterine cramps during a menstrual period; occurs in the lower abdomen; can be sharp, intermittent, dull, or aching. ■ Dysfunctional uterine bleeding = characterized by abnormal bleeding, often due to an imbalance in hormone level changes. ■ Hypermenorrhea (menorrhagia) = an excessive amount of menstrual flow over a period of more than 7 days. ■ Hypomenorrhea = an unusually small amount of menstrual flow during a shortened regular menstrual period. ■ Menometrorrhagia (intermenstrual bleeding) = excessive uterine bleeding at both the usual time of menstrual periods and at other irregular intervals. ■ Metrorrhagia (spotting) = uterine bleeding between menstrual periods ■ Oligomenorrhea = infrequent or very light menstruation in a woman with previously normal periods. ■ Polymenorrhea = the occurrence of menstrual cycles more frequently than is normal. ■ Premature menopause = condition in which the ovaries cease functioning before age 40 years due to disease, a hormonal disorder, or surgical removal; causes infertility and often brings on menopausal symptoms. ■ Premenstrual syndrome = a group of symptoms experienced by some women within the 2-week period before menstruation; symptoms can include bloating, swelling, headaches, mood swings, and breast discomfort. ■ Premenstrual dysphoric disorder = condition associated with severe emotional and physical problems that are closely linked to the menstrual cycle; symptoms occur regularly in the second half of the cycle and end when menstruation begins or shortly thereafter. ● Pathology Of Pregnancy And Childbirth ○ Pregnancy ■ Abortion = the interruption or termination of pregnancy before the fetus is viable. ● Spontaneous abortion (miscarriage) → usually occurs early in the pregnancy and is due to an abnormality or genetic disorder. ● Induced abortion → caused by human intervention; achieved through the use of drugs or suctioning. ● Therapeutic abortion → done for medical purposes ■ Ectopic pregnancy (extrauterine pregnancy) = potentially dangerous condition in which a fertilized egg is implanted and begins to develop outside of the uterus; ■ Gestational diabetes mellitus ■ Infertility = the inability of a couple to achieve pregnancy after 1 year of regular, unprotected intercourse, or the inability of a woman to carry a pregnancy to a live birth. ■ Preeclampsia (pregnancy-induced hypertension) = a complication of pregnancy characterized by hypertension (high blood pressure), edema (swelling), and proteinuria (an abnormally high level of protein in the urine). ■ Eclampsia = a more serious form of preeclampsia; characterized by convulsions and sometimes coma; treatment includes the delivery of the fetus. ■ HELLP syndrome = life-threatening pregnancy complication characterized by hemolysis (breakdown of red blood cells), elevated liver enzymes, and low platelet count; occurs in 10–20% of pregnant women with severe preeclampsia or eclampsia and can occur during the third trimester of pregnancy or after delivery; treatment includes delivery of the fetus and careful monitoring to prevent serious maternal complications including hemorrhage and death. ■ Rh factor - see Chapter 5 ○ Childbirth ■ Abruptio placentae (placental abruption) = disorder in which the placenta separates from the uterine wall before the birth of the fetus; is a leading cause of fetal death. ■ Breech presentation = occurs when the buttocks or feet of the fetus are positioned to enter the birth canal first instead of the head. ■ Placenta previa = the abnormal implantation of the placenta in the lower portion of the uterus; symptoms include painless, sudden-onset bleeding during the third trimester. ● Previa → appearing before or in front of ■ Premature infant (preemie) = a fetus born before the 37th week of gestation. ■ Stillbirth = the birth of a fetus that died before or during delivery. ■ Postpartum depression = mood disorder characterized by feelings of sadness and the loss of pleasure in normal activities that can occur shortly after giving birth; one cause is the rapid change in the hormone levels that occurs after giving birth; when the depression is severe, treatment is required. ● Diagnostic Procedures Of The Female Reproductive System ○ Colposcopy = the direct visual examination of the tissues of the cervix and vagina; is performed using a binocular magnifier known as a colposcope. ○ Endometrial biopsy = a small amount of the tissue from the lining of the uterus is removed for microscopic examination; most often used to determine the cause of abnormal vaginal bleeding. ○ Endovaginal ultrasound = performed to determine the cause of abnormal vaginal bleeding; performed by placing an ultrasound transducer in the vagina so that the sound waves can create images of the uterus and ovaries. ○ Hysterosalpingography = a radiographic examination of the uterus and fallopian tubes (hyster/o → uterus; salping/o → fallopian tubes); it requires the instillation of radiopaque contrast material into the uterine cavity and fallopian tubes to make them visible. ■ Instillation → the slow introduction of a liquid into a body part by pouring or injection. ○ Hysteroscopy = the direct visual examination of the interior of the uterus and fallopian tubes; performed by using the magnification of a hysteroscope. ○ Pap smear = an exfoliative biopsy of the cervix; performed to detect conditions that can be early indicators of cervical cancer. ■ Exfoliative → cells are scraped from the tissue and examined under a microscope. ■ Speculum → used to enlarge the opening of the vagina during the examination of the cervix and vagina. ○ Diagnostic Procedures Related to Pregnancy and Childbirth ■ Pregnancy test = performed to detect an unusually high level of the human chorionic gonadotropin (HCG) hormone in either a blood or urine specimen, which is usually an indication of pregnancy; a home pregnancy test uses a urine specimen, whereas a pregnancy test based on a blood specimen at a doctor's office usually provides more reliable results. ■ Fetal ultrasound ■ First trimester screening (combined screening) = performed between 11 and 13 weeks of pregnancy and involves an ultrasound and a finger-stick blood test; combined results of these two measurements, plus the mother's age, detect if the fetus is at increased risk for Down syndrome; diagnostic tests, such as amniocentesis or chorionic villus sampling, are recommended for those at increased risk for this condition. ■ Chorionic villus sampling = the examination of cells retrieved from the chorionic villi, which are minute, vascular projections on the chorion; is performed between the 8th and 10th weeks of pregnancy to search for genetic abnormalities in the developing fetus. ■ Amniocentesis = a surgical puncture with a needle to obtain a specimen of amniotic fluid; usually obtained after the 14th week of pregnancy; used to evaluate fetal health and to diagnose certain congenital disorders. ■ Pelvimetry = a radiographic study to measure the dimensions of the pelvis to evaluate its capacity to allow passage of the fetus through the birth canal. ● Treatment Procedures Of The Female Reproductive System ○ Medications ■ Contraceptive = taken to lessen the likelihood of pregnancy. ■ Birth control pills → a form of hormones that are administered as an oral contraceptive; other forms of this type of contraceptive are available as an injection, a patch, an implant, and an inserted ring. ■ Diaphragm = a barrier contraceptive that prevents the sperm from reaching and fertilizing the egg. ■ Intrauterine device = a molded plastic contraceptive inserted through the cervix into the uterus to prevent pregnancy. ■ Condom = prevents pregnancy when used correctly; is the only contraceptive method that will also prevent the transmission of sexually transmitted diseases (STDs). ■ Hormone replacement therapy = the use of the female hormones estrogen and progesterone to replace those the body no longer produces during and after perimenopause; estradiol and progestin are commonly used synthetic forms of estrogen and progesterone, respectively. ○ The Ovaries and Fallopian Tubes ■ Oophorectomy (ovariectomy) = the surgical removal of one or both ovaries (oophor → ovary); if both ovaries are removed in a premenopausal woman, the patient experiences surgical menopause. ■ Salpingectomy = the surgical removal of one or both fallopian tubes ■ Salpingooophorectomy = the surgical removal of a fallopian tube and ovary. ● Bilateral salpingo-oophorectomy → the removal of both of the fallopian tubes and ovaries. ■ Tubal ligation = a surgical sterilization procedure in which the fallopian tubes are sealed or cut to prevent sperm from reaching a mature ovum. ○ The Uterus, Cervix, and Vagina ■ Colpopexy (vaginofixation) = the surgical fixation of a prolapsed vagina to a surrounding structure such as the abdominal wall ■ Conization (cone biopsy) = the surgical removal of a cone-shaped specimen of tissue from the cervix; performed as a diagnostic procedure or to remove abnormal tissue. ■ Colporrhaphy = the surgical suturing of a tear in the vagina ■ Dilation and curettage (D & C) = a surgical procedure in which the cervix is dilated and the endometrium of the uterus is scraped away; can be performed as a diagnostic or a treatment procedure. ● Dilation → the expansion of an opening ● Curettage → the removal of material from the surface by scraping with an instrument known as a curette. ■ Myomectomy = the surgical removal of uterine fibroids ■ Hysterectomy = the surgical removal of the uterus ● Total hysterectomy (complete hysterectomy) = the uterus and cervix are removed; can be performed through the vagina or laparoscopically through the abdomen. ● Partial/subtotal hysterectomy → the uterus is removed and the cervix is left in place. ● Radical hysterectomy (bilateral hysterosalpingo-oophorectomy) = includes the surgical removal of the ovaries and fallopian tubes, the uterus and cervix, plus nearby lymph nodes; if this surgery is performed before natural menopause, the patient immediately experiences surgical menopause; most commonly performed to treat uterine cancer. ○ Mammoplasty ■ Mammoplasty (mammaplasty) = a cosmetic operation on the breasts ● Breast augmentation = mammoplasty performed to increase breast size, often for cosmetic reasons. ○ Augmentation → the process of adding to make larger ● Breast reduction = mammoplasty performed to decrease and reshape excessively large, heavy breasts; is sometimes done to relieve back and neck pain. ● Mastopexy (breast lift) = a mammoplasty to affix sagging breasts in a more elevated position. ○ Treatment Procedures Related to Pregnancy and Childbirth ■ Cesarean section (C-section) = the delivery of the child through an incision in the maternal abdominal and uterine walls; usually performed when a vaginal birth would be unsafe for either the mother or baby. ■ VBAC → vaginal birth after a cesarean ■ Episiotomy = a surgical incision made into the perineum to enlarge the vaginal orifice to prevent tearing of the tissues as the infant moves out of the birth canal (episi/o → vulva) ■ Episiorrhaphy = the surgical suturing to repair an episiotomy ■ Incubator = an apparatus for maintaining an environment of controlled temperature, humidity, and oxygen concentration for a premature or ill newborn. ■ Assisted reproductive technology = techniques used to aid an infertile couple in achieving a viable pregnancy. ● Artificial insemination (intrauterine insemination) = a technique in which sperm from a woman's partner or from a donor are introduced into the vagina or uterus during the ovulatory phase of her menstrual cycle. ● In vitro fertilization = a procedure in which mature ova are removed from the mother to be fertilized; the resulting embryos are transferred into the uterus with the hope that they will implant and continue to develop as a normal pregnancy. ○ In vitro → in an artificial environment such as a test tube